[Robotic mitral valve repair: perioperative and seven-year follow-up results].

摘要

OBJECTIVE: To summarize surgical experience during the conduction of robotic mitral valve repair and evaluate the long-term follow-up results. METHODS: From January 2007 to September 2014, 110 consecutive patients underwent robotic mitral valve repair under da Vinci Surgical System (Intuitive Surgical, USA) in Chinese PLA General Hospital were enrolled. The age of the patients was 14 to 65(45±12) years old. The male to female ratio was 2.3∶1. Among them, 95.5%(105/110) of the cases was diagnosed as mitral regurgitation and 4.5%(5/110) of them was diagnosed as mitral stenosis, and most of them (63.3%) needed triangular or quadrangular resection. Nitinol U-clips (58.1%), running suture (31.2%) and Cor-Knot™ suture device (10.8%) were used to secure the annuloplasty ring. The operative data were collected and patients were regularly followed up echocardiographically as long as 7 years. RESULTS: All the surgeries were finished by the same surgeon. One case required conversion to sternotomy. The mean cardiopulmonary bypass (CPB) and cross-clamp time was 70 to 152 (121.0±34.3) and 47 to 122 (82.6±25.3) minutes respectively. After surgery, one death (0.91%) and two cases of stroke (1.82%) occurred. Three cases of early prosthetic failure (2.73%) were noticed. All patients were successfully followed up for a median of 50 (range, 1 month to 7 years) months and 94.5%(104/110) of them had no re-operation. CONCLUSION: Robotic mitral valve repair is a safe and effective surgical method with excellent long-term outcomes.